BEAVER DAM COMMUNITY HOSPITALS INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- BEAVER DAM COMMUNITY HOSPITALS INC (EIN 39-1157876)
- Tax period
- 2019-07-01 to 2020-06-30
- Filed
- 2021-05-12
- IRS object ID
- 202141329349302249
- Schema version
- 2019v5.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-05-12T11:59:37-05:00 | ReturnTs |
| Tax Period End | 2020-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4200 Wells Fargo Ctr 90 S 7th | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391157876 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BEAVER DAM COMMUNITY HOSPITALS INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % CATHY BUKOWSKI VP OF FINANC | InCareOfNm |
| Business Name Control | BEAV | BusinessNameControlTxt |
| Phone | 9208877181 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 707 South University Avenue | AddressLine1Txt |
| City | Beaver Dam | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53916 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GORDON T EDWARDS | PersonNm |
| Person Title | CFO/COO | PersonTitleTxt |
| Phone | 9208877181 | PhoneNum |
| Signature | 2021-05-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MONROE J GIERL | PreparerPersonNm |
| PTIN | P01413237 | PTIN |
| Phone | 6123055000 | PhoneNum |
| Preparation | 2021-05-12 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Marshfield Medical Center-Beaver Dam | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Susan Turney MD CEO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 N Oak Avenue | AddressLine1Txt |
| City | Marshfield | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54449 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $113,418,359 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.bdch.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1972 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | WE ENRICH LIVES TO CREATE HEALTHY COMMUNITIES THROUGH ACCESSIBLE, AFFORDABLE, COMPASSIONATE HEALTH CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 1015 | TotalEmployeeCnt |
| Total Volunteers | 300 | TotalVolunteersCnt |
| Total Gross UBI | $4,887,926 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $214,863 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,565,615 | PYContributionsGrantsAmt |
| CY Contributions Grants | $23,607 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $107,873,368 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $106,380,768 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,067,362 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,432,204 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,663,209 | PYOtherRevenueAmt |
| CY Other Revenue | $448,883 | CYOtherRevenueAmt |
| PY Total Revenue | $115,169,554 | PYTotalRevenueAmt |
| CY Total Revenue | $109,285,462 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $127,188 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $2,997,968 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $54,148,666 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $55,509,209 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $57,602,552 | PYOtherExpensesAmt |
| CY Other Expenses | $53,267,871 | CYOtherExpensesAmt |
| PY Total Expenses | $111,878,406 | PYTotalExpensesAmt |
| CY Total Expenses | $111,775,048 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,291,148 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,489,586 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $188,667,538 | TotalAssetsBOYAmt |
| Total Assets EOY | $193,989,750 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $88,296,365 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $82,350,383 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $100,371,173 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $111,639,367 | NetAssetsOrFundBalancesEOYAmt |
| Mission | WE ENRICH LIVES TO CREATE HEALTHY COMMUNITIES THROUGH ACCESSIBLE, AFFORDABLE, COMPASSIONATE HEALTH CARE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $97,616,635 | ExpenseAmt |
| Grant | $2,997,968 | GrantAmt |
| Revenue | $101,788,360 | RevenueAmt |
| Desc | BEAVER DAM COMMUNITY HOSPITALS, INC. (BDCH) IS A NOT-FOR-PROFIT 60-BED COMMUNITY HOSPITAL LOCATED IN BEAVER DAM, WISCONSIN THAT PROVIDES BOTH INPATIENT AND OUTPATIENT SERVICES. THERE ARE MEDICAL/SURGICAL, TELEMETRY, INTENSIVE CARE, OBSTETRICS, AND NURSERY UNITS ON THE INPATIENT FLOORS. THERE IS AN EMERGENCY ROOM, URGENT CARE, SURGERY CENTER, REHABILITATION CENTER, PAIN CLINIC, OUTPATIENT MEDICAL ONCOLOGY CLINIC, MEDICAL IMAGING, PHARMACY DEPARTMENT AND A WOUND CENTER. BDCH ALSO OPERATES A 115-BED NURSING HOME AND PROVIDES HOME HEALTH AND HOSPICE SERVICES. | Desc |
| Total Program Service Expenses | $97,616,635 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | Yes (true) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (true) | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 104 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 1015 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CATHY BUKOWSKI VP OF FINANC | PersonNm |
| Phone | 7153875511 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 N OAK AVENUE | AddressLine1Txt |
| City | MARSHFIELD | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54449 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| SUSAN TURNEY MD | |||||||||
| BOARD MEMBER/MCHS CEO | 1.0 | 44.0 | Yes (X) | $0 | $2,421,029 | $290,941 | |||
| NARAYANA MURALI MD | |||||||||
| BOARD MEMBER/MCHS CSO | 1.0 | 41.0 | Yes (X) | $0 | $923,371 | $56,431 | |||
| JERARD JENSEN | |||||||||
| MCHS GENERAL COUNSEL | 1.0 | 44.0 | $0 | $871,749 | $54,160 | Yes (X) | |||
| KIMBERLY J MILLER | |||||||||
| FRMR PRES/CEO THRU MAR 2019 | 0.0 | 0.0 | $857,347 | $0 | $31,906 | Yes (X) | |||
| GORDON EDWARDS | |||||||||
| MCHS CFO/COO | 1.0 | 44.0 | $0 | $759,168 | $56,820 | Yes (X) | |||
| PAUL PALMER | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $485,552 | $208,931 | $36,567 | Yes (X) | |||
| JOSEPH PUCCINELLI | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $491,986 | $206,989 | $29,152 | Yes (X) | |||
| ROBERT SEIPEL | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $462,927 | $200,913 | $43,243 | Yes (X) | |||
| RUWAN DISSANAYAKE MD | |||||||||
| BOARD MEMBER | 1.0 | 41.0 | Yes (X) | $0 | $472,736 | $55,431 | |||
| JOSEPH GILENE | |||||||||
| CEO | 40.0 | 0.0 | $471,455 | $0 | $0 | Yes (X) | |||
| JASON SMITH | |||||||||
| CHIEF MEDICAL OFFICER | 40.0 | 0.0 | $426,611 | $0 | $38,520 | Yes (X) | |||
| MOLLY MEIER | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $278,507 | $0 | $38,634 | Yes (X) | |||
| MARK BUGHER | |||||||||
| CHAIR | 1.0 | 3.0 | Yes (X) | $0 | $33,000 | $0 | |||
| CHUCK NASON | |||||||||
| SECRETARY | 1.0 | 3.0 | Yes (X) | $0 | $7,500 | $0 | |||
| MARK BRADLEY | |||||||||
| VICE CHAIR | 1.0 | 2.0 | Yes (X) | $0 | $6,500 | $0 | |||
| JOHN BALTUS | |||||||||
| TREASURER | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| SUSAN SUTTER | |||||||||
| BOARD MEMBER | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,474,385 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $6,111,886 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $731,805 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 36 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| A1 EXCEL HOSPITALIST GROUP | |||||
| 18111 W WISCONSIN AVE | BROOKFIELD | WI | 53045 | MEDICAL SVCS | $1,109,170 |
| HALL RENDER KILLIAN | |||||
| PO BOX 714570 | CINCINNATI | OH | 45271 | PROFESSIONAL SVCS | $772,270 |
| GREENFIELD REHABILITATION AGENCY | |||||
| 19395 W CAPITOL DRIVE | BROOKFIELD | WI | 53045 | MEDICAL SVCS | $666,381 |
| ZIEGLER CAPITAL MANAGEMENT LLC | |||||
| 70 WEST MADISON STREET | CHICAGO | IL | 60602 | PROFESSIONAL SVCS | $151,522 |
| CLIFTONLARSONALLEN LLP | |||||
| PO BOX 775351 | CHICAGO | IL | 60677 | PROFESSIONAL SVCS | $130,601 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $18,840 | RelatedOrganizationsAmt |
| All Other Contributions | $4,767 | AllOtherContributionsAmt |
| Total Contributions | $23,607 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 622110 | $101,665,886 | $98,185,844 | $3,480,042 |
| DAYCARE REVENUE | 622110 | $1,235,774 | $222,050 | $1,013,724 |
| CAFETERIA REVENUE | 622110 | $773,575 | $773,575 | |
| ALL OTHER OPERATING REVENUE | 622110 | $2,705,533 | $2,597,950 | $107,583 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $106,380,768 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,757,533 | TotalRevenueColumnAmt |
| Exclusion | $1,757,533 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,164,348 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,724,406 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $439,942 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $439,942 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $286,577 | UnrelatedBusinessRevenueAmt |
| Exclusion | $153,365 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,083,162 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,401,641 | SecuritiesAmt |
| Other | $6,850 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $681,521 | SecuritiesAmt |
| Other | -$6,850 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $674,671 | TotalRevenueColumnAmt |
| Exclusion | $674,671 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | VENDING REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $8,941 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,941 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $8,941 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $109,285,462 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $101,788,360 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $4,887,926 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,585,569 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,160 | TotalAmt |
| Program Services | $52,160 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,945,808 | TotalAmt |
| Program Services | $2,945,808 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,253,703 | TotalAmt |
| Management And General | $1,253,703 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,740,161 | TotalAmt |
| Program Services | $34,208,109 | ProgramServicesAmt |
| Management And General | $5,532,052 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,317,972 | TotalAmt |
| Program Services | $2,078,972 | ProgramServicesAmt |
| Management And General | $239,000 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,339,723 | TotalAmt |
| Program Services | $8,271,900 | ProgramServicesAmt |
| Management And General | $1,067,823 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,857,650 | TotalAmt |
| Program Services | $2,666,508 | ProgramServicesAmt |
| Management And General | $191,142 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,803 | TotalAmt |
| Management And General | $68,803 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $115,046 | TotalAmt |
| Management And General | $115,046 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $278,433 | TotalAmt |
| Management And General | $278,433 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,015,285 | TotalAmt |
| Program Services | $7,970,908 | ProgramServicesAmt |
| Management And General | $3,044,377 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $194,622 | TotalAmt |
| Program Services | $6,596 | ProgramServicesAmt |
| Management And General | $188,026 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,524,787 | TotalAmt |
| Program Services | $941,409 | ProgramServicesAmt |
| Management And General | $583,378 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,330,349 | TotalAmt |
| Program Services | $2,138,254 | ProgramServicesAmt |
| Management And General | $192,095 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,875,538 | TotalAmt |
| Program Services | $2,548,799 | ProgramServicesAmt |
| Management And General | $326,739 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $251,150 | TotalAmt |
| Program Services | $215,148 | ProgramServicesAmt |
| Management And General | $36,002 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $122,746 | TotalAmt |
| Program Services | $67,926 | ProgramServicesAmt |
| Management And General | $54,820 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,179,391 | TotalAmt |
| Program Services | $1,179,391 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,797,705 | TotalAmt |
| Program Services | $9,797,705 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,832 | TotalAmt |
| Program Services | $93,832 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $13,893,967 | $13,761,312 | $132,655 |
| BAD DEBT EXPENSE | $3,924,286 | $3,924,286 | |
| REPAIRS & MAINT | $2,485,464 | $2,097,291 | $388,173 |
| WI MEDICAID ACCESS TAX | $2,120,874 | $2,120,874 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $995,593 | TotalAmt |
| Program Services | $529,447 | ProgramServicesAmt |
| Management And General | $466,146 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $111,775,048 | TotalAmt |
| Program Services | $97,616,635 | ProgramServicesAmt |
| Management And General | $14,158,413 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,907 | BOYAmt |
| EOY | $22,756,049 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,607,574 | BOYAmt |
| EOY | $2,692,164 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,601,826 | BOYAmt |
| EOY | $10,942,944 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,554,884 | BOYAmt |
| EOY | $2,641,874 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,630,566 | BOYAmt |
| EOY | $1,138,637 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $197,921,619 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $120,023,151 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $84,114,428 | BOYAmt |
| EOY | $77,898,468 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,374,118 | BOYAmt |
| EOY | $71,616,438 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $322,028 | BOYAmt |
| EOY | $196,981 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,420,207 | BOYAmt |
| EOY | $4,106,195 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $188,667,538 | BOYAmt |
| EOY | $193,989,750 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,570,445 | BOYAmt |
| EOY | $13,316,815 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,919 | BOYAmt |
| EOY | $66,879 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,545,075 | BOYAmt |
| EOY | $49,134,677 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $213,901 | BOYAmt |
| EOY | $252,050 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,757,000 | BOYAmt |
| EOY | $8,637,192 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,136,025 | BOYAmt |
| EOY | $10,942,770 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $88,296,365 | BOYAmt |
| EOY | $82,350,383 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $97,950,966 | BOYAmt |
| EOY | $100,057,343 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,420,207 | BOYAmt |
| EOY | $11,582,024 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,371,173 | BOYAmt |
| EOY | $111,639,367 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $188,667,538 | BOYAmt |
| EOY | $193,989,750 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$2,489,586 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,006,992 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $12,750,788 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| Agent Trustee Etc | false | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (true) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,030,364 | OtherCostOrOtherBasisAmt |
| Book Value | $4,030,364 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $80,892,217 | OtherCostOrOtherBasisAmt |
| Depreciation | $33,936,226 | DepreciationAmt |
| Book Value | $46,955,991 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,828,679 | OtherCostOrOtherBasisAmt |
| Depreciation | $902,603 | DepreciationAmt |
| Book Value | $1,926,076 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $107,118,452 | OtherCostOrOtherBasisAmt |
| Depreciation | $82,161,316 | DepreciationAmt |
| Book Value | $24,957,136 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,051,907 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,023,006 | DepreciationAmt |
| Book Value | $28,901 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $77,898,468 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| ACCRUED PENSION LIABILITY | $10,672,770 |
| OTHER PAYROLL LIABILITY | $270,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $10,942,770 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 SCH D PART IV LINE 2B | RESIDENT TRUST FUNDS ARE FUNDS THAT ARE THE RESIDENTS' THAT ARE DESPOSITED IN A SEPARATE BANK ACCOUNT. THESE ARE TRACKED SEPARARELY FROM BDCH'S FUNDS AND BELONG TO THE RESIDENTS. SECURITY DEPOSITS ARE DEPOSITS PAID TO BDCH UPON ENTERING INTO A RENTAL AGREEMENT FOR RESIDENTS AND ARE DUE BACK TO THE TENANTS UPON TERMINATION OF THEIR RENTAL AGREEMENT. |
| FORM 990 SCH D PART X LINE 2 | THE ORGANIZATION APPLIES FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES (ASC 740), WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S FINANCIAL STATEMENTS. ASC 740 PRESCRIBES A MORE-LIKELY THAN-NOT RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN. UNDER ASC 740, TAX POSITIONS WILL BE EVALUATED FOR RECOGNITION, DERECOGNITION, AND MEASUREMENT USING CONSISTENT CRITERIA AND WILL PROVIDE MORE INFORMATION ABOUT THE UNCERTAINTY IN INCOME TAX ASSETS AND LIABILITIES. BASED ON AN ANALYSIS PREPARED BY THE SYSTEM, IT WAS DETERMINED THAT THE APPLICATION OF ASC 740 HAD NO MATERIAL EFFECT ON THE ORGANIZATION AT SEPTEMBER 30, 2020 OR 2019. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,228,107 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,228,107 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01140 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,655,031 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,714,037 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,940,994 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07360 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $16,883,138 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,714,037 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,169,101 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08500 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $884,469 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $884,469 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00820 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,707 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $17,707 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $902,176 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $902,176 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00840 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,785,314 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,714,037 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,071,277 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09340 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,636,035 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $19,493,170 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $29,543,389 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$10,050,219 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | None | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BEAVER DAM COMMUNITY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 707 S UNIVERSITY AVENUE | AddressLine1Txt |
| City | BEAVER DAM | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53916 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.bdch.com | WebsiteAddressTxt |
| State License | 199 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BEAVER DAM COMMUNITY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | Yes (true) | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.bdch.com/community-health-needs | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.bdch.com/community-health-needs | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 0. | FPGFamilyIncmLmtDscntCarePct |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | www.bdch.com/financial-assistance | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | www.bdch.com/financial-assistance | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Supplemental Information | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990 Sch H Part V Line 2 | EFFECTIVE MAY 1, 2019, MCHS HOSPITALS, INC. BECAME THE SOLE MEMBER OF BEAVER DAM COMMUNITY HOSPITALS, INC. (BDCH) DBA MARSHFIELD MEDICAL CENTER-BEAVER DAM THROUGH A MEMBER SUBSTITUTION AGREEMENT. |
| Form 990 Sch H Part V Line 5 | BEAVER DAM COMMUNITY HOSPITALS, INC. (BDCH) GATHERED QUALITATIVE INFORMATION AND PERSPECTIVES ON COMMUNITY HEALTH NEEDS THROUGH ONE-ON-ONE AND SMALL GROUP INTERVIEWS WITH KEY COMMUNITY STAKEHOLDERS. REFER TO PAGES 30 AND 31 OF THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR THE LIST OF COMMUNITY MEMBERS, ORGANIZATIONS AND SPECIFIC PARTICIPANTS. |
| Form 990 Sch H Part V Line 6b | THE CHNA WAS CONDUCTED WITH THE FOLLOWING NON-HOSPITAL FACILITIES: -DODGE COUNTY -JEFFERSON COUNTY |
| Form 990 Sch H Part V Line 7d | THE COMMUNITY HEALTH NEEDS ASSESSMENT IS OFTEN DISCUSSED IN PRESENTATIONS THE HOSPITAL PARTICIPATES IN, SUCH AS CHAMBER OF COMMERCE AND OTHER LOCAL CIVIC AND COMMUNITY ORGANIZATION EVENTS. |
| Form 990 Sch H Part V Line 11 | BDCH HAS ELECTED TO TAKE A HOLISTIC APPROACH BY ENGAGING WITH HEALTHWAYS, INC. TO CREATE A BLUE ZONES DESIGNATED AREA COMPASSING DODGE COUNTY. IT IS THROUGH THIS PARTNERSHIP THAT BDCH HAS ADDRESSED NUTRITIONAL AND PHYSICAL ACTIVITY BARRIERS AND SUBSTANCE ABUSE CONCERNS IN FY20. THERE ARE SEVERAL RESTAURANTS AND WORKPLACES WITHIN DODGE COUNTY THAT ARE BLUE ZONES CERTIFIED OPTIONS TO THEIR CUSTOMER (THROUGH HEALTHY MENU OPTIONS) AND EMPLOYEES (THROUGH CREATION OF WALKING MOAIS OR OTHER HEALTH-RELATED ACTIVITIES). IN ADDITION, THE BLUE ZONES PROJECT HELD SEVERAL COMMUNITY-SPECIFIC ENGAGEMENT EVENTS THROUGHOUT THE YEAR, FOCUSING ON THE ENVIRONMENT, FOOD, ALCOHOL AND TOBACCO. ANOTHER EXAMPLE OF HOW BDCH IS PROMOTING THE HEALTH OF THE COMMUNITY IS THROUGH ITS ENGAGEMENT WITH HEALTHWAYS, INC. TO CREATE A BLUE ZONES AREA THAT ENCOMPASSES DODGE COUNTY. THROUGH THIS PARTNERSHIP WITH HEALTHWAYS, INC. BDCH ADDRESSES AND PROMOTES HEALTH LIFESTYLES THROUGH NUTRITIONAL AND PHYSICAL ACTIVITY AS WELL AS FOCUS ON SUBSTANCE ABUSE CONCERNS. BUSINESSES AND COMMUNITIES PARTNER TOGETHER WITH BDCH TO PROVIDE HEALTHY OPTIONS AND LIFESTYLES FOR THEIR CUSTOMERS, EMPLOYEES AND CITIZENS. ALL OF THE BLUE ZONES PROGRAMS ARE OFFERED TO THE COMMUNITY FREE OF CHARGE. BDCH WORKS WITH THE COUNTY AND CITY MUNICIPALITIES, FAITH-BASED ORGANIZATIONS, GROCERY STORES, AND SCHOOLS TO IMPROVE THE HEALTH AND WELL-BEING OF COUNTY RESIDENTS. |
| Form 990 Sch H Part V | FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY WEBSITE: WWW.BDCH.COM/FINANCIAL-ASSISTANCE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| HILLSIDE MANOR | ||||
| 803 S UNIVERSITY AVENUE | BEAVER DAM | WI | 53916 | SKILLED NURSING FACILITY |
| REMEMBRANCE HOME | ||||
| 1810 NORTH SPRING STREET | BEAVER DAM | WI | 53916 | DEMENTIA-SPECIFIC COMMUNITY-BASED RESIDENTIAL FACILITY |
| EAGLES WINGS | ||||
| 408 STONE STREET | BEAVER DAM | WI | 53916 | COMMUNITY-BASED RESIDENTIAL FACILITY |
| BEAVER DAM REFERENCE LAB | ||||
| 707 SOUTH UNIVERSITY AVENUE | BEAVER DAM | WI | 53916 | REFERENCE LAB |
| HILLSIDE HOMECARE AND HOSPICE | ||||
| 709 SOUTH UNIVERSITY AVENUE | BEAVER DAM | WI | 53916 | HOME HEALTH AGENCY |
| Stone Terrace Retirement Living Center | ||||
| 819 South University Avenue | Beaver Dam | WI | 53916 | Residential Care Apartment Complex |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 SCH H PART I LINE 3C | Beaver Dam Community Hospital ("BDCH") grants financial assistance if they (A) Receive emergency medical care or medically necessary care, (B) Submit a complete community care application including required supporting documents and (C) Have household income less than 150% of the federal poverty guidelines. BDCH may also give financial assistance based on a propensity-to-pay formula that is provided and run by a third-party vendor. Form 990 Sch H Part I Line 6a IN ADDITION TO ITS COMMUNITY BENEFITS REPORT WHICH IT PREPARES, BDCH PREPARES AN ANNUAL REPORT EACH YEAR THAT IS DISTRIBUTED TO MEMBERS OF THE COMMUNITIES IT SERVES. WITHIN THE ANNUAL REPORT IS A SECTION REGARDING COMMUNITY BENEFITS. |
| Form 990 Sch H Part I Line 7 | CHARITY CARE IS DETERMINED BY UTILIZING THE TOTAL AMOUNT FROM THE PATIENT BILLING SYSTEM THAT IS WRITTEN OFF USING THE CHARITY CARE ALLOWANCE CHARGE CODES FROM THE CHARGEMASTER. THE TOTAL CHARITY CARE AMOUNT REPORTED ON LINE 7A COLUMN (C) IS REDUCED TO COST BY APPLYING BDCH'S COST TO CHARGE RATES AS CALCULATED ON IRS SCHEDULE H, WORKSHEET 2. |
| Form 990 Sch H Part III Line 2 | BAD DEBT EXPENSE IS REPORTED AT COST USING A COST-TO-CHARGE RATIO. BDCH BELIEVES THAT ITS CHARITY CARE AND RELATED COMMUNITY BENEFIT IS UNDERESTIMATED DUE TO PATIENTS THAT MAY POTENTIALLY QUALIFY FOR CHARITY CARE BUT CHOOSE NOT TO APPLY FOR IT. IN ADDITION, THERE IS ADDITIONAL BAD DEBT EXPENSE DUE TO CHARITY CARE APPLICATIONS THAT ARE MISSING INFORMATION AND ARE THEREFORE INCOMPLETE. |
| Form 990 Sch H Part III Line 4 | PATIENT ACCOUNTS RECEIVABLE ARE REDUCED FOR EXPLICIT PRICE CONCESSIONS AND BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AS AN IMPLICIT PRICE CONCESSION. IN EVALULATING THE COLLECTABILITY OF PATIENTS' ACCOUNTS RECEIVABLE, THE SYSTEM ANALYZES ITS PAST HISTORY AND CONTRACTUAL TERMS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE. FOR RECEIVABLES ASSOCIATED WITH PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ADDITIONAL IMPLICIT DISCOUNT, IF NECESSARY (I.E. FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND CO-PAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID FOR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND CO-PAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE SYSTEMS RECORDS AN IMPLICIT DISCOUNT IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENT BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE. |
| Form 990 Sch H Part III Line 8 | THE ALLOWABLE MEDICARE COST ON PART III, LINE 6 IS DETERMINED USING THE FY 2020 FILED MEDICARE COST REPORT. THE REIMBURSEMENT FROM MEDICARE IS DEDUCTED FROM THE ESTIMATED COST TO DETERMINE THE ESTIMATED SHORTFALL FROM THE MEDICARE PROGRAM. BDCH RECOGNIZES THAT THE ESTIMATED SHORTFALL IS ACTUALLY GREATER THAN WHAT IS INCLUDED IN PART III, LINE 7 DUE TO THE NON-ALLOWABLE COSTS PER THE MEDICARE COST REPORT. THIS SHORTFALL OF $10,050,219 IS NOT CLASSIFIED AS COMMUNITY BENEFIT. HOWEVER, BDCH BELIEVES IT IS AN IMPORTANT CONTRIBUTION MADE BY THE HOSPITAL TO SUPPORT ITS MISSION OF DELIVERING EXCELLENCE ACROSS A CONTINUUM OF SERVICES, EVEN IF BDCH IS NOT COMPENSATED FULLY FOR DOING SO. IN ADDITION, MANY OF THESE PATIENTS WOULD QUALIFY FOR MEDICAID AS SEVERAL PATIENTS CARRY IT AS A SECONDARY PLAN, SO THEREFORE, IF THE MEDICARE PROGRAM DID NOT EXIST, MEDICAID WOULD BE THE PRIMARY INSURANCE FOR MANY PATIENTS, WHICH IS CONSIDERED TO BE COMMUNITY BENEFIT. |
| Form 990 Sch H Part III Line 9b | BDCH MAKES EVERY EFFORT TO DETERMINE WHETHER A PATIENT IS ELIGIBLE FOR CHARITY CARE OF OTHER FINANCIAL ASSISTANCE. AS DESCRIBED IN PART VI, QUESTION 3, BDCH HAS PROCESSES IN PLACE TO INFORM PATIENTS OF OUR CHARITY CARE POLICY AND TO PROVIDE THEM WITH INFORMATION IN APPLYING FOR OTHER THIRD-PARTY OR GOVERNMENT REIMBURSEMENT. IF THE PATIENT'S INCOME LEVEL QUALIFIES THEM FOR CHARITY CARE, THE FULL AMOUNT OF THEIR ACCOUNT BALANCE IS WRITTEN OFF AS CHARITY CARE. IF THE PATIENT DOES NOT AUTOMATICALLY QUALIFY FOR CHARITY CARE, THEY CAN PROVIDE ADDITIONAL INCOME INFORMATION TO DETERMINE IF THEY QUALIFY FOR FULL CHARITY CARE WRITE-OFFS. IF THE PATIENT DOES NOT QUALIFY FOR CHARITY CARE, THEN THE PATIENTS IS RESPONSIBLE FOR THE REMAINING BALANCE. THE PATIENT HAS THE OPTION TO MAKE INSTALLMENT PAYMENTS WITH NO INTEREST. IN THE EVENT THAT THE PATIENT DEFAULTS ON THEIR INSTALLMENT PAYMENTS OR DOES NOT COOPERATE WITH BCDH'S COLLECTION EFFORTS, THE ACCOUNT WILL BE SENT TO A COLLECTION AGENCY. |
| Form 990 Sch H Part VI Line 2 | EVERY 5 YEARS, THE HEALTH DEPARTMENTS OF DODGE AND JEFFERSON COUNTY AND THE CITY OF WATERTOWN CONDUCT A JOINT COMPREHENSIVE CHNA AND COMPILE A REPORT CONTAINING AN ANALYSIS OF THE QUALITATIVE AND QUANTITATIVE INFORMATION GATHERED FROM SEVERAL SOURCES INCLUDING FOCUS GROUPS, THE US CENSUS BUREAU, AND THE BEHAVIOR RISK FACTOR SURVEILLANCE SYSTEM, AMONG OTHERS. THE REPORT INCORPORATES DATA TO ADDRESS ALL 11 HEALTH PRIORITIES IN THE WISCONSIN STATE HEALTH PLAN. BDCH HAS OBTAINED A COPY OF THE FULL REPORT AND UTILIZES THE INFORMATION TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY. IN ADDITION, BDCH SUPPORT CHURCH HEALTH SERVICES, A LOCAL ORGANIZATION COMMITTED TO SERVING LOW-INCOME PATIENTS WITH NO INSURANCE, AND MEET WITH THEM TO ASSESS THE NEEDS OF THE COMMUNITY. |
| Form 990 Sch H Part VI Line 3 | AT BDCH, THE COMMUNITY CARE POLICY IS COMMUNICATED UPON REGISTRATION TO SELF-PAY PATIENTS FOR INPATIENT CARE, AT WHICH TIME PATIENTS MAY BE QUALIFIED FOR COMMUNITY CARE IMMEDIATELY. FOR OUTPATIENT SELF-PAY PATIENTS, CONTACT INFORMATION IS INCLUDED IN LETTERS AND STATEMENTS, ENCOURAGING THE PATIENTS TO CONTACT BDCH IS THEY DO NOT HAVE THE MEANS TO PAY THEIR MEDICAL EXPENSES. WHEN CONTACTED, QUESTIONS ARE ASKED TO DETERMINE IF THE PATIENT MAY QUALIFY. IF SO, A PACKET IS MAILED OUT FOR COMPLETION. |
| Form 990 Sch H Part VI Line 4 | BEAVER DAM COMMUNITY HOSPITALS, INC. (BDCH) SERVES THE GREATER DODGE AND COLUMBIA COUNTY REGION. THE HOME SERVICES PROGRAM ALSO TRAVELS TO PATIENTS IN THEIR HOMES UP TO 30 MILES AWAY. THE POPULATION OF THE AREA IS APPROXIMATELY 145,000 PEOPLE. DEMOGRAPHICALLY, ABOUT 20% OF THE POPULATION IS UNDER AGE 18, ABOUT 62% IS AGED 18-64 AND ABOUT 18% IS AGE 65 AND OLDER. THE HOSPITAL SERVES PATIENTS OF ALL AGES. ALTHOUGH THE POPULATION IS PRIMARILY CAUCASIAN, THERE IS A GROWING HISPANIC POPULATION. MULTIPLE LANGUAGES ARE SPOKEN IN THE AREA, AND THEREFORE INTERPRETATION SERVICES ARE PROVIDED FOR ALL PATIENTS. |
| Form 990 Sch H Part VI Line 5 | BDCH HAS A LONG HISTORY OF SERVING THE COMMUNITY OF BEAVER DAM AND THE SURROUNDING REGION. BDCH HAS CONTINUALLY GROWN SERVICES TO RESPOND TO THE NEEDS OF ITS PATIENTS ACROSS THE REGION IN CARRYING OUT ITS MISSION OF PROVIDING EXCELLENCE ACROSS THE CONTINUUM. BDCH OFFERS SEVERAL HEALTH AND COMMUNITY PROGRAMS AT NO OR LOW COST SUCH HEALTH AND SAFETY FAIRS, LACTATION CONSULTATION SERVICES, SUPPORT GROUPS, HEALTH SCREENINGS, MEMORY CARE CLINICS, WELLNESS CLASSES, MEALS ON WHEELS, AND JOINT REPLACEMENT SEMINARS, FOOT CLINICS, PACEMAKER CLINICS, AND SELF-REQUESTED, WALK-IN LAB TESTING AMONG OTHERS. THE AFFILIATION WITH MARSHFIELD CLINIC HEALTH SYSTEM INCREASED SPECIALTY SERVICES PROVIDED TO THE COMMUNITY THAT PREVIOUSLY REQUIRED PATIENTS TO TRAVEL A MINIMUM OF 45 TO LARGER FACILITIES. BDCH HAS AN OPEN MEDICAL STAFF, A LOCAL COMMUNITY ADVISORY BOARD COMPRISED OF COMMUNITY MEMBERS, AND USES ITS SURPLUS FUNDS TO REINVEST IN TECHNOLOGY AND PROGRAM SERVICES TO BETTER SERVE ITS PATIENTS. BDCH SUPPORT CHURCH HEALTH SERVICES, A LOCAL ORGANIZATION COMMITTED TO PROVIDING HEALTH SERVICES TO LOW-INCOME PATIENTS WITHOUT INSURANCE. BDCH PARTICIPATES AS A DROP-OFF SITE FOR SHARPS AND IN THE WISCONSIN HOSPITAL EMERGENCY PREPAREDNESS PLAN WHOSE PURPOSE IS TO MEET A COMMUNITY NEED BY BRINGING ORGANIZATIONS TOGETHER IN THE EVENT OF AN EMERGENCY IN A COLLABORATIVE AND ORGANIZED MANNER. BDCH'S LEADERSHIP STAFF PARTICIPATE IN MANY LOCAL ORGANIZATIONS THROUGHOUT THE REGION. ANOTHER EXAMPLE OF HOW BDCH IS PROMOTING THE HEALTH OF THE COMMUNITY IS THROUGH ITS ENGAGEMENT WITH HEALTHWAYS, INC. TO CREATE A BLUE ZONES DESIGNATED AREA THAT ENCOMPASSES DODGE COUNTY. THROUGH THIS PARTNERSHIP WITH HEALTHWAYS, INC. BDCH ADDRESSES AND PROMOTES HEALTHY LIFESTYLES THROUGH NUTRITIONAL AND PHYSICAL ACTIVITY AS WELL AS FOCUSES ON SUBSTANCE ABUSE CONCERNS. BUSINESSES AND COMMUNITIES PARTNER TOGETHER WITH BDCH TO PROVIDE HEALTHY OPTIONS AND LIFESTYLES FOR THEIR CUSTOMERS, EMPLOYEES AND CITIZENS. ALL OF THE BLUE ZONES PROGRAMS ARE OFFERED TO THE COMMUNITY FREE OF CHARGE. BDCH WORKS WITH THE COUNTY AND CITY MUNICIPALITIES, FAITH-BASED ORGANIZATIONS, GROCERY STORES, AND SCHOOLS TO IMPROVE THE HEALTH AND WELL-BEING OF COUNTY RESIDENTS. |
| Form 990 Sch H Part VI Line 6 | BDCH BECAME PART OF AN AFFILIATED HEALTHCARE SYSTEM, MARSHFIELD CLINIC HEALTH SYSTEM (MCHS), ON MAY 1, 2019. MCHS DEEPLY BELIEVES IN PROMOTING COMMUNITY HEALTH THROUGH BUILDING AND SUSTAINING STRONG INTERNAL AND EXTERNAL PARTNERSHIPS AND COLLABORATIONS. FOR THIS REASON, MCHS AND ITS AFFILIATED ENTITIES WORK TOGETHER INTERNALLY AND EXTERNALLY WITH COMMUNITY PARTNERS, STAKEHOLDERS AND RESIDENTS TO IMPROVE COMMUNITY HEALTH. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BEAVER DAM HOSPITAL FOUNDATION INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 707 S UNIVERSITY AVE | AddressLine1Txt |
| City | BEAVER DAM | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53916 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 391499140 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $37,000 | CashGrantAmt |
| Purpose Of Grant | GENERAL SUPPORT | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | CHARITY CARE | GrantTypeTxt |
| Recipient | 500 | RecipientCnt |
| Cash Grant | $2,945,808 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Form 990 Sch I Part I Line 2 | FormAndLineReferenceDesc |
| Explanation | THE GRANTS GIVEN TO OUTSIDE ORGANIZATIONS WERE GIVEN TO A RELATED ENTITY. FUNDS TRANSFERRED ARE MONITORED THROUGH THE INTERNAL FINANCIAL REPORTING PROCESS. BEAVER DAM COMMUNITY HOSPITALS, INC. PROVIDES EMERGENCY AND MEDICALLY NECESSARY HEALTH CARE SERVICES FOR FREE OR AT DISCOUNTED RATES TO PATIENTS WHO MEET CERTAIN ELIGIBILITY CRITERIA. PATIENTS SEEKING FINANCIAL ASSISTANCE APPLY BY COMPLETING A FINANCIAL ASSISTANCE APPLICATION. FREE CARE IS AVAILABLE FOR PATIENTS WITH INCOME AND EXCESS ASSET VALUES AT OR BELOW 150% OF THE FEDERAL POVERTY GUIDELINES. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Housing Allowance Or Residence | Yes (X) | HousingAllowanceOrResidenceInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | Yes (true) | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | Yes (true) | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (true) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | Yes (true) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SUSAN TURNEY MD | ||||||||||||||
| BOARD MEMBER/MCHS CEO | $0 | $1,724,990 | $0 | $350,200 | $0 | $345,839 | $0 | $270,641 | $0 | $22,505 | $0 | $2,714,175 | $0 | $241,400 |
| RUWAN DISSANAYAKE MD | ||||||||||||||
| BOARD MEMBER | $0 | $343,493 | $0 | $110,079 | $0 | $19,164 | $0 | $29,241 | $0 | $28,395 | $0 | $530,372 | $0 | $0 |
| NARAYANA MURALI MD | ||||||||||||||
| BOARD MEMBER/MCHS CSO | $0 | $740,819 | $0 | $131,250 | $0 | $51,302 | $0 | $29,241 | $0 | $28,854 | $0 | $981,466 | $0 | $0 |
| JERARD JENSEN | ||||||||||||||
| MCHS GENERAL COUNSEL | $0 | $763,409 | $0 | $102,974 | $0 | $5,366 | $0 | $29,241 | $0 | $27,124 | $0 | $928,114 | $0 | $0 |
| GORDON EDWARDS | ||||||||||||||
| MCHS CFO/COO | $0 | $634,788 | $0 | $82,380 | $0 | $42,000 | $0 | $29,241 | $0 | $29,784 | $0 | $818,193 | $0 | $0 |
| JOSEPH GILENE | ||||||||||||||
| CEO | $471,455 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $471,455 | $0 | $0 | $0 |
| JASON SMITH | ||||||||||||||
| CHIEF MEDICAL OFFICER | $360,256 | $0 | $65,900 | $0 | $455 | $0 | $11,200 | $0 | $27,320 | $0 | $465,131 | $0 | $0 | $0 |
| KIMBERLY J MILLER | ||||||||||||||
| FRMR PRES/CEO THRU MAR 2019 | $325,523 | $0 | $104,050 | $0 | $427,774 | $0 | $9,583 | $0 | $22,323 | $0 | $889,253 | $0 | $0 | $0 |
| JOSEPH PUCCINELLI | ||||||||||||||
| PHYSICIAN | $471,601 | $205,343 | $0 | $0 | $20,385 | $1,646 | $11,200 | $0 | $16,833 | $1,880 | $520,019 | $208,869 | $0 | $0 |
| PAUL PALMER | ||||||||||||||
| PHYSICIAN | $465,922 | $207,887 | $0 | $0 | $19,630 | $1,044 | $11,200 | $0 | $23,926 | $2,202 | $520,678 | $211,133 | $0 | $0 |
| ROBERT SEIPEL | ||||||||||||||
| PHYSICIAN | $442,723 | $199,589 | $0 | $0 | $20,204 | $1,324 | $12,200 | $0 | $29,993 | $1,811 | $505,120 | $202,724 | $0 | $0 |
| MOLLY MEIER | ||||||||||||||
| PHYSICIAN | $278,129 | $0 | $0 | $0 | $378 | $0 | $11,200 | $0 | $27,434 | $0 | $317,141 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990 Sch J Part I Line 1a | THE ORGANIZATION MAY OCCASIONALLY REIMBURSE OR PROVIDE A HOUSING ALLOWANCE FOR KEY EXECUTIVES IN ORDER TO ASSIST WITH RELOCATING TO THE AREA. THE ORGANIZATION MAY ALSO CONTRIBUTE TO OR REIMBURSE FOR HEALTH AND SOCIAL CLUB DUES AS DEEMED NECESSARY IN ORDER TO SUPPORT A BUSINESS NEED. |
| Form 990 Sch J Part I Line 3 | THE MARSHFIELD CLINIC HEALTH SYSTEM'S (MCHS) INDEPENDENT COMPENSATION COMMITTEE (THE COMMITTEE) HAS FINAL AUTHORITY FOR APPROVING COMPENSATION AND BENEFITS OF ALL DISQUALIFIED PERSONS EMPLOYED BY ANY OF THE ORGANIZATIONS IN THE SYSTEM. THE COMMITTEE USES COMBINATIONS OF THE FOLLOWING TO EVALUATE COMPENSATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE, AND WRITTEN EMPLOYMENT CONTRACTS. |
| Form 990 Sch J Part I Line 4a | SEVERANCE KIMBERLY J MILLER - $139,156 |
| Form 990 Sch J Part I Line 4b | 457(F) PLAN SUSAN TURNEY, MD - $254,127 |
| Form 990 Sch J Part I Line 5a | SEVERAL INDIVIDUALS MAY RECEIVE INCENTIVE COMPENSATION BASED ON A VARIETY OF FACTORS, INCLUDNG NOT ONLY FINANCIAL MEASURES SUCH AS REVENUE GROWTH OR EARNINGS, BUT ALSO QUALITY, SERVICE, MARKET EXPANSION, COMMUNITY & EMPLOYEE ENGAGEMENT, AND OTHER OUTCOMES OR EXPECTATIONS SET BY THE BOARD AND/OR CEO. ANY PERFORMANCE BONUS IS SUBJECT TO REVIEW BY THE SYSTEM'S INDEPENDENT COMPENSATION COMMITTEE FOR REASONABLENESS. |
| Form 990 Sch J Part I Line 6a | SEVERAL INDIVIDUALS MAY RECEIVE INCENTIVE COMPENSATION BASED ON A VARIETY OF FACTORS, INCLUDING NOT ONLY FINANCIAL MEASURES SUCH AS REVENUE GROWTH OR EARNINGS, BUT ALSO QUALITY, SERVICE, MARKET EXPANSION, COMMUNITY & EMPLOYEE ENGAGEMENT, AND OTHER OUTCOMES OR EXPECTATIONS SET BY THE BOARD AND/OR CEO. ANY PERFORMANCE BONUS IS SUBJECT TO REVIEW BY THE SYSTEM'S INDEPENDENT COMPENSATION COMMITTEE FOR REASONABLENESS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990 Part IV Line 4 | MARSHFIELD CLINIC HEALTH SYSTEM (INCLUDING BEAVER DAM COMMUNITY HOSPITALS, INC.) IS A MEMBER OF VARIOUS HEALTHCARE ASSOCIATIONS (I.E. WISCONSIN HOSPITAL ASSOCIATION) THAT MAY PERFORM SOME LOBBYING ACTIVITY. ALL ASSOCIATED DUES ARE DISCLOSED ON THE FORM 990 OF MARSHFIELD CLINIC HEALTH SYSTEM, INC. |
| Form 990 Part IV Line 24a | BEAVER DAM COMMUNITY HOSPITALS, INC. IS PART OF THE MARSHFIELD CLINIC HEALTH SYSTEM OBLIGATED GROUP. SINCE THE OBLIGATED GROUP IS RESPONSIBLE FOR ALL OUTSTANDING FINANCED DEBT OBLIGATIONS, ALL BOND RELATED REPORTING IS DISCLOSED ON THE FORM 990 OF MARSHFIELD CLINIC HEALTH SYSTEM, INC. |
| Form 990 Part VI Line 2 | BOARD MEMBERS CHUCK NASON AND MARK BRADLEY HAVE A FAMILY RELATIONSHIP. |
| Form 990 Part VI Line 6 | MCHS HOSPITALS, INC. (A WISCONSIN NONSTOCK, NONPROFIT ORGANIZATION DESCRIBED IN CODE SECTION 501(C)(3)) IS THE SOLE MEMBER OF BEAVER DAM COMMUNITY HOSPITALS, INC. |
| Form 990 Part VI Line 7a | MCHS HOSPITALS, INC. (AS THE SOLE MEMBER) HAS THE RESERVE POWER TO APPOINT OR REMOVE MEMBERS OF THE BOARD OF DIRECTORS OF BEAVER DAM COMMUNITY HOSPITALS, INC. |
| Form 990 Part VI Line 7b | MCHS HOSPITALS, INC. (THE SOLE MEMBER) HAS THE RIGHT TO APPROVE ANY CHANGES TO THE ARTICLES OF INCORPORATION AND BYLAWS OF BEAVER DAM COMMUNITY HOSPITALS, INC. MCHS HOSPITALS, INC. (THE SOLE MEMBER) HAS THE RIGHT TO INITIATE AND APPROVE LONG-TERM BORROWING AND OTHER FORMS OF LONG-TERM INDEBTEDNESS, INITIATE AND APPROVE THE PURCHASE, SALE OR ENCUMBRANCE OF REAL AND PERSONAL PROPERTY AND APPROVE OR DISAPPROVE ANNUAL OPERATING AND CAPITAL BUDGETS. MCHS HOSPITALS, INC. (THE SOLE MEMBER) ALSO HAS THE RIGHT TO INITIATE AND APPROVE ANY OF THE FOLLOWING ACTIONS: MERGER, CONSOLIDATION, AFFILIATION OR JOINT VENTURE WITH ANY OTHER ENTITY OR ENTITIES; LIQUIDATION, REORGANIZATION OR DISSOLUTION OF THE ORGANIZATION; FILING OF A VOLUNTARY PETITION IN BANKRUPTCY; ANY CHANGE IN CONTROL OF THE ORGANIZATION. |
| Form 990 Part VI Line 11b | Marshfield Clinic Health System, Inc. engages a public accounting firm to prepare and review the Form 990 in addition to review by the System CFO/COO. PRIOR TO FILING THE FORM WITH THE IRS, THE CFO AND HIS/HER DESIGNEE WILL PROVIDE TO EACH MEMBER OF THE SYSTEM'S AUDIT AND COMPLIANCE COMMITTEE (A SUBCOMMITTEE OF THE BOARD OF DIRECTORS) A COPY IN ELECTRONIC OR PAPER FORM OF THE COMPLETED FORM 990 (AND ALL REQUIRED SCHEDULES) FOR REVIEW. |
| Form 990 Part VI Line 12c | ALL OFFICERS, BOARD DIRECTORS, AND KEY EMPLOYEES OF EVERY MARSHFIELD CLINIC HEALTH SYSTEM (MCHS) ENTITY, AS WELL AS ANY OTHER PERSON DESIGNATED BY THE AUDIT AND COMPLIANCE COMMITTEE (ACC) TO BE A REQUIRED REPORTER BY VIRTUE OF HIS OR HER POSITION AT A SYSTEM ENTITY, SHALL ANNUALLY COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. SUCH FORMS SHALL BE DISTRIBUTED AND RECORDED BY THE SYSTEM'S DESIGNATED COMPLIANCE OFFICER. ALL FINANCIAL INTERESTS DISCLOSED AS PART OF THE ANNUAL DISCLOSURE PROCESS SHALL BE REVIEWED BY THE ACC. THE ACC SHALL INFORM THE BOARD OF DISCLOSED FINANCIAL INTERESTS WHICH MAY BEAR UPON OR RELATE TO A TRANSACTION UPON WHICH THE BOARD OR ANOTHER BOARD, COMMITTEE OR OTHER BODY OF A SYSTEM ENTITY, MAY DELIBERATE OR ACT. IN ADDITION TO THE ANNUAL DISCLOSURES, IF AT ANY TIME BETWEEN ANNUAL DISCLOSURES, A REQUIRED REPORTER BECOMES AWARE THAT THE BOARD, OR A BOARD, COMMITTEE OR OTHER BODY, OF ANY SYSTEM ENTITY MAY DELIBERATE OR ACT UPON ANY TRANSACTION THAT MAY HAVE ANY BEARING OF ANY KIND UPON, OR MAY RELATE IN ANY MANNER TO, AN EXISTING, INTENDED OR EXPECTED FINANCIAL INTEREST OF THE REQUIRED REPORTER, HE OR SHE SHALL DISCLOSE THE FINANCIAL INTEREST TO THE RELEVANT SYSTEM ENTITY BOARD, COMMITTEE OR BODY CHAIR, AS WELL AS TO THE SYSTEM'S COMPLIANCE OFFICER, IN ADVANCE OF ANY DELIBERATIONS OR ACTION, WRITTEN DISCLOSURE OF THE EXISTENCE, NATURE AND EXTENT OF HIS OR HER FINANCIAL INTEREST. ALL WRITTEN OR ORAL DISCLOSURES OF FINANCIAL INTERESTS SHALL BE RECORDED IN THE MINUTES OF THE BOARD AND BY THE OFFICE OF THE COMPLIANCE OFFICER. THE COMPLIANCE OFFICER SHALL DISCLOSE THE COMPLETED FORMS AS NECESSARY TO THOSE MCHS EMPLOYEES RESPONSIBLE FOR COMPLETION OF THE IRS FORM 990. |
| Form 990 Part VI Line 15a | THE SYSTEM'S INDEPENDENT COMPENSATION COMMITTEE (COMPENSATION COMMITTEE) SHALL HAVE FINAL AUTHORITY FOR APPROVING COMPENSATION AND BENEFITS OF ALL DISQUALIFIED PERSONS (AS THAT TERM IS DEFINED IN 4958 OF THE INTERNAL REVENUE CODE (THE CODE)) EMPLOYED BY THE CORPORATION, INCLUDING BUT NOT LIMITED TO THE CORPORATION'S CEO. THE TERM DISQUALIFIED PERSONS INCLUDES (BUT IS NOT LIMITED TO) ANY PERSON (OR THE PERSON'S FAMILY MEMBER) WHO WAS, AT ANY TIME DURING THE 5-YEAR PERIOD ENDING ON THE DATE OF THE TRANSACTION, IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF THE ORGANIZATION. IT SHALL BE THE RESPONSIBILITY OF THE COMPENSATION COMMITTEE TO INSURE THAT THE SYSTEM DOES NOT PAY AN AMOUNT THAT EXCEEDS REASONABLE COMPENSATION FOR ANY DISQUALIFIED PERSON. THE COMPENSATION COMMITTEE AND ITS OPERATING PROCEDURES SHALL BE DESIGNED TO ESTABLISH THE REBUTTABLE PRESUMPTION OF REASONABLENESS OF COMPENSATION OUTLINED IN TREASURY REG. SEC. 53.4958-6 WITH RESPECT TO EACH DISQUALIFIED PERSON. IN DETERMINING REASONABLENESS OF COMPENSATION, THE COMPENSATION COMMITTEE SHALL EVALUATE APPROPRIATE INFORMATION AS TO COMPARABILITY OF COMPENSATION, INCLUDING BUT NOT LIMITED TO: COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR COMPARABLE POSITIONS; THE AVAILABILITY OF SIMILAR SERVICES IN THE SYSTEM'S GEOGRAPHIC AREA; CURRENT COMPENSATION SURVEYS COMPILED BY INDEPENDENT FIRMS; AND ACTUAL WRITTEN JOB OFFERS FROM SIMILAR INSTITUTIONS. THE COMPENSATION COMMITTEE SHALL HAVE INDEPENDENT AUTHORITY TO OBTAIN OUTSIDE EXPERT OPINIONS ON THE REASONABLENESS AND FAIR MARKET VALUE OF COMPENSATION AND GATHER OTHER INFORMATION IT CONSIDERS NECESSARY OR APPROPRIATE TO MAKE ITS DECISIONS ON COMPENSATION. THE COMPENSATION COMMITTEE SHALL TIMELY DOCUMENT ITS DETERMINATION OF REASONABLENESS OF COMPENSATION. |
| Form 990 Part VI Line 19 | BEAVER DAM COMMUNITY HOSPITALS, INC. DOES NOT MAKE ITS CURRENT GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UNLESS INCLUDED AS PART OF A FORM THAT IS REQUIRED TO BE PUBLICLY AVAILABLE. |
| Form 990 Part X Line 20 | BEAVER DAM COMMUNITY HOSPITALS, INC. IS PART OF THE MARSHFIELD CLINIC HEALTH SYSTEM OBLIGATED GROUP. SINCE THE OBLIGATED GROUP IS RESPONSIBLE FOR ALL OUTSTANDING FINANCED DEBT OBLIGATIONS, ALL BOND RELATED REPORTING IS DISCLOSED ON THE FORM 990 OF MARSHFIELD CLINIC HEALTH SYSTEM, INC. |
| Form 990 Part XI Line 9 | OTHER CHANGES IN NET ASSETS OR FUND BALANCES: NET ASSETS RELEASED FROM RESTRICTION: 5,500,000 NET ASSET TRANSFERS WITH RELATED ORGS: 7,250,788 ------------------ TOTAL OTHER CHANGES IN NET ASSETS: 12,750,788 |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| DODGE HEALTH ENTERPRISES LLC | |||||||||
| 715 S UNIVERSITY AVE | BEAVER DAM | WI | 53916 | 391538653 | REFERENCE LAB | WI | -$709,180 | $726,669 | BDCH |
| DELMAN DEVELOPMENT LLC | |||||||||
| 707 S UNIVERSITY AVE | BEAVER DAM | WI | 53916 | 272375085 | REAL ESTATE | WI | -$43,804 | $1,272,103 | BDCH |
| BEAVER DAM MEDICAL BUILDING 2 LLC | |||||||||
| 705 S UNIVERSITY AVE | BEAVER DAM | WI | 53916 | 391157876 | BUILDING MGMT | WI | $752,983 | $8,648,813 | BDCH |
| WELL LIFE HOME MEDICAL EQUIPMENT AND SUP | |||||||||
| 707 S UNIVERSITY AVE | BEAVER DAM | WI | 53916 | 812463679 | DME | WI | $0 | $0 | BDCH |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| BEAVER DAM HOSPITAL FOUNDATION INC | ||||||||||
| 707 S UNIVERSITY AVE | BEAVER DAM | WI | 53916 | 391499140 | PHILANTHROPY | WI | 501(c)(3) | 10 | BDCH | Yes (true) |
| MCHS HOSPITALS INC | ||||||||||
| 1000 N OAK AVE | MARSHFIELD | WI | 54449 | 810977948 | HOSPITAL | WI | 501(c)(3) | 3 | MCHS | false |
| FLAMBEAU HOSPITAL INC | ||||||||||
| 98 SHERRY AVE | PARK FALLS | WI | 54552 | 390973724 | HOSPITAL | WI | 501(c)(3) | 3 | MCHS HOSP | false |
| LAKEVIEW MEDICAL CENTER INC | ||||||||||
| 1700 W STOUT ST | RICE LAKE | WI | 54868 | 390837206 | HOSPITAL | WI | 501(c)(3) | 3 | MCHS HOSP | false |
| FAMILY HEALTH CENTER OF MARSHFIELD INC | ||||||||||
| 1000 N OAK AVE | MARSHFIELD | WI | 54449 | 391681547 | COM HLTH CTR | WI | 501(c)(3) | 7 | NA | false |
| MARSHFIELD CLINIC INC | ||||||||||
| 1000 N OAK AVE | MARSHFIELD | WI | 54449 | 390452970 | MEDICAL SVCS | WI | 501(c)(3) | 3 | MCHS | false |
| SECURITY HEALTH PLAN OF WISCONSIN INC | ||||||||||
| 1515 N ST JOSEPH AVE | MARSHFIELD | WI | 54449 | 391572880 | HMO | WI | 501(c)(4) | N/A | MCHS | false |
| MARSHFIELD CLINIC HEALTH SYSTEM INC | ||||||||||
| 1000 N OAK AVE | MARSHFIELD | WI | 54449 | 461495343 | SUPPORT ORG | WI | 501(c)(3) | 12-TYPE III | NA | false |
| MCHS FOUNDATION INC | ||||||||||
| 1000 N OAK AVE | MARSHFIELD | WI | 54449 | 812822823 | PHILANTHROPY | WI | 501(c)(3) | 7 | MCHS | false |
| MEMORIAL HOSPITAL INC | ||||||||||
| 216 SUNSET PL | NEILLSVILLE | WI | 54456 | 390806828 | HOSPITAL | WI | 501(c)(3) | 3 | MCHS HOSP | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE DIAGNOSTIC & TREATMENT CENTER LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3401 CRANBERRY BLVD | AddressLine1Txt |
| City | WESTON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54476 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 200691634 | EIN |
| Primary Activities | MEDICAL SVCS | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| General Or Managing Partner | false | GeneralOrManagingPartnerInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | None | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Comments